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Query: UMLS:C0085693 (
acute appendicitis
)
3,606
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 46-year-old woman with a history of hemorrhoids presented with right-sided abdominal pain and rectal bleeding. Preoperative imaging and intraoperative observations were suggestive of
acute appendicitis
. The surgical pathology of removed appendix was consistent with granulomatous appendicitis. The patient was evaluated again in two months due to persistent hematochezia and new onset of left lower quadrant abdominal pain. A diagnostic colonoscopy revealed mildly edematous mucosa in the descending colon, sigmoid colon, and rectum, and a rectal biopsy revealed patchy chronic
proctitis
. The biopsy of anal canal mucosa showed acute and chronic granulomatous inflammation. Based on her clinical presentation and pathology results, the diagnosis of chronic active
proctitis
secondary to Crohn's disease (CD) was made. There is a debate on necessity of follow-up on patients with appendiceal CD after appendectomy as previously reported appendiceal CD usually follows a benign course post-appendectomy. However, our patient's case progressed from granulomatous appendicitis to CD with severe GI bleeding and
proctitis
within only two months post-appendectomy. A high index of suspicion is needed in patients with a history of granulomatous appendicitis and lower GI bleeding to ensure prompt diagnosis and timely treatment.
...
PMID:Acute Granulomatous Appendicitis and Lower Gastrointestinal Bleeding as the Presenting Features of Crohn's Disease. 3172 40